KARMA BUMPS REGISTRATION & HEALTH WAIVER FORM
FOR ANTE/PRENATAL YOGA WITH MINA
During this pregnancy, have you experienced any of the following?
Other, Please give details
Please give details of any of the above which you have selected, or any other health issues which you feel may have some bearing on your yoga practice.
Are you currently taking medications or has serious allergies that should be made known to medical personnel in case of an emergency, please indicate them here:
Please note aromatherapy and pure essential oils may be used in some of the yoga classes.
If allergic to essential oils, please advise before each class.
Prior to this pregnancy, have you suffered any injury or undergone any surgery (e.g caesarean birth, knee surgery )
that may have some bearings on your yoga practice?
If so, please give details below.
If applicable would you like to share any information on previous
pregnancies or miscarriages that may have some bearings on your yoga practice?
If so, please give details below
Are there any reasons why GP approval may be required before you can participate in the class
If YES to the above question
Any extra help we need to provide (for example because of a disability):
If YES to the above question please let us know how we can help below
Is there any other information you feel you need to share prior to your first yoga class? How did you hear about Ministry of Yoga Prenatal Yoga Classes with Mina?
Have you practiced yoga before?
Please give details of how long, what style of yoga? Why have you come to yoga, and what do you hope to gain from it?
How did you hear about Ministry of Yoga Prenatal Yoga Classes with Mina?
Please acknowledge the following disclaimer:
• I have declared all information regarding my health and the health of the baby that might affect my successful participation in the Pregnancy Yoga classes.
• I take full responsibility for my body and my baby.
• If I have any worries, I will seek the advice of my medical professional
before proceeding with Jasmin Colangelo’s Pregnancy Yoga classes.
• I will promptly inform my teacher Mina Bhama of any health issues that arise during the course of my pregnancy.
In further consideration of permitting myself to participate in the yoga class,
I knowingly, voluntarily, and expressly waive any claim I may have against Karma Kids Uk Ltd, Jade Lawrence and Mina Bhama or any other teacher working for Karma Kids Yoga UK and the owner/lessor of the Premises for injury or damages that I may sustain while on the Premises as a result of participating in the yoga class.
I, my heirs or legal representatives irrevocably covenant not to sue and forever release, waive, and discharge any other claims of any kind whatsoever against Karma Kids Uk Ltd, Jade Lawrence & Mina Bhama or any other teacher working for Karma Kids Yoga UK Ltd or the owner/lessor of the Premises for any personal injury, property loss or damage, or wrongful death, whether caused by negligence or otherwise.
I have read the above release and waiver of liability and fully understand its contents.
I acknowledge this disclaimer, I voluntarily agree to the terms and conditions, stated & confirm that that the details I have provided are correct
by ticking the box below
I agree to
Karma Kids UK LTD/Mina Bhama keeping a record of this form for health and safety reasons under our GDPR & Privacy guidelines
Karma Kids aims to provide a safe and enjoyable experience
To help us do this, please note the following important information
You should arrive at the studio at the class time, using any one way system set in place by the Ministry of Yoga.
We cannot accept any loss, responsibility or damage to any personal belongings
Please ensure you follow social distancing in accordance with Gov guidance whilst in the main areas of the Ministry of Yoga
Masks should be worn on the premises
Please check in using the Covid QR code
Equipment will be kept to a minimum & will not be shared between participants/classes
All equipment & the Karma Kids Uk Ltd studio will be cleaned between classes
To avoid Covid transmission you have the option of bringing/providing your own yoga mat
No food is to be consumed within the yoga studio. *
Only water in closed containers (no glasses or cups) is to be drunk within the yoga studtios. *
No hot drinks are allowed.*
In the event of a fire, visitors are asked to make their way to the nearest available exit.
We reserve the right to cancel a course if there is a problem with the class size. In the event of cancellation, your course fee will be returned and will endeavour to offer you an opportunity to attend another course. If you wish to cancel your place before the course starts, you must give 14 days’ notice before the start date.
Thank you for taking the time to register for
Karma Bumps Pregnancy yoga classes
with Mina Bhama